Lower Back Pain

Get long term relief from debilitating lower back pain!

Approximately one-third of the adult population in UK are affected by low back pain each year. Studies reveal that back pain alone accounts for 40% of sickness absence and overall it costs more than £10 billion for the UK economy.

Low back pain can decrease the quality of life of a person considerably and often leads to frustration and depression.

Mostly lower back pain often goes away with some rest and pain medication, but if it occurs with any of the following lower back pain red flags, you should consult a doctor without delay:

  • Inflammation or swelling on the back
  • Persistent back pain where lying down or resting does not help
  • Numbness or shooting pain down the legs or arms
  • Pain that reaches below the knees
  • Loss of bladder and/or bowel control. 
  • Weight loss
  • Fever
  • Severe stomach pain.

Most back pain conditions can be treated effectively with rest, medication & physical therapy. Only in very few cases, back pain treatment requires spinal injections or surgery.

Have Low Back Pain?

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What causes Lower Back Pain?

The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around freely. Back pain is generally caused by strain, tension, or injury to any of these components.

Road accidents, injuries caused due to lifting something too heavy improperly and degeneration due to ageing are the major causes of lower back pain.

But there are other causes:


The muscles and ligaments in the back can stretch or tear due to excess activity.

Slipped Disc:

A herniated disc, which is also known as a slipped or ruptured disc, occurs when the cartilage surrounding the disc pushes against the spinal cord or nerve roots. The cushion that sits between the spinal vertebrae extends outside its normal position. This can result in compression of the nerve root as it exits from the spinal cord and through the vertebral bones. Disc injury usually occurs suddenly after lifting something or twisting the back.


Sciatica can occur with a herniated disc if the disc presses on the sciatic nerve. The sciatic nerve connects the spine to the legs. As a result, sciatica can cause pain in the legs and feet. This pain usually feels like burning, or pins and needles.

Spinal stenosis: 

Spinal stenosis is when the spinal column narrows, putting pressure on the spinal cord and spinal nerves.

Spine Deformity:

Conditions such as Scoliosis, kyphosis, and lordosis cause abnormal curvatures in the spine. These are congenital conditions that are usually first diagnosed during childhood or adolescence. The abnormal curvature causes pain and poor posture because it places pressure on the muscles, tendons, ligaments and vertebrae.

Other conditions:

There are a number of other conditions that cause lower back pain such as Arthritis, Fibromyalgia, Spondylitis, Cauda equina syndrome (CES) and Osteoporosis.

Additional health conditions that can cause lower back pain include kidney and bladder problems, pregnancy, endometriosis, ovarian cysts, uterine fibroids, and cancer.

Whether acute or chronic, low back pain should never be ignored. Mr Rajesh is a world-class spine specialist in London committed to providing you with long-term relief from back pain. From the initial diagnosis, consultation, to treatment (both conservative therapies or a surgical procedure), you are in good hands in London with spine surgeon Mr Rajesh.

Call: 0203 1500 259 – for a Consultation Appointment.


Diagnosis for Lower Back Pain

It is important to find the exact cause of your lower back pain so that it can be effectively treated. The problem is that the symptoms for sciatica, slipped discs and piriformis syndrome are pretty much similar. Only an experienced Consultant Spine Surgeon would know how to read the minute details and diagnose your condition precisely.

Mr Rajesh will use one or more of the following diagnostic procedures to pinpoint the cause of your lower back pain caused by a pinched nerve in the back.

Physical Examination:

Specialist physical assessment of your spinal joints, ligaments & muscles helps Mr Rajesh understand where the pain is. He will be able to assess the cause and extent of your back pain with these examinations.

You may need other tests:

MRI Scans:

Consultant Spine Surgeon Mr Rajesh will need magnetic resonance imaging (MRI) scans to look at your back muscles, soft tissues, ligaments, black disc, disc prolapse and spinal stenosis. This information along with your story will help Mr Rajesh decide and recommend the best plan of action.

MRI scan is the best investigation to get information on the soft tissues.


Standing X-rays from your front and the side will give Mr Rajesh a good assessment of your spinal alignment, if there are some spinal curvature, scoliosis or fractures.

CT scans:

Computerised Tomography (CT) is not needed routinely as it brings in the risk of significant radiation. But it is very useful to look at the extent of damage to your bones in your spine. It therefore gives valuable information of the structure and shape of the spine.

Blood tests:

Blood tests are not routinely needed in the investigation of low back pain. These are useful if the you have fever, infection or suspicion of inflammation.

Diagnosing the underlying cause of your lower back pain at the right time is essential to start your ideal treatment plan!

Treatment for Lower Back Pain

Experienced back pain specialist in London, Mr Mangattil Rajesh, takes the time to understand the underlying causes for your low back pain. Mr Rajesh then creates a tailor-made multi-disciplinary back pain treatment plan specifically for you.


This back pain treatment plan involves one or more of the following:


Non-steroidal anti-inflammatory drugs are prescribed to help relieve pain and reduce inflammation.

  • Paracetamol
  • Codine
  • Naproxen

Muscle relaxants like diazepam are also prescribed in some cases to treat muscle spasms and ease nerve-damage pain.

Physiotherapy & Exercises:

Mr. Rajesh believes in treating most of the back pain issues through non-surgical ways such as lifestyle correction, exercises, and physiotherapy as part of his comprehensive lower back pain treatment in London.

Spine injections:

Mr Rajesh prescribes epidural, facet joint, nerve root or sacroiliac steroid joint injections for some cases to give immediate relief from acute lower back pain. 

Spine Injections relieve pain instantly for cases where extreme pain and discomfort are debilitating. This also helps the patient heal quickly from the condition causing their lower back pain. This is a very safe and minimally invasive procedure that gives excellent pain relief for months. It also provides an opportunity for people with lower back pain to break the cycle of pain and heal completely.

Spine specialist Mr Rajesh takes a multi-disciplinary approach to back pain treatment in London. He believes in treating and healing his back pain patients without surgery in most cases.

In some instances, if there is a herniated disc that is causing pressure on your nerves after spine steroid injections,  Mr Rajesh might suggest a Minimally Invasive Surgery.

Minimally Invasive Spine Surgery:

Surgery is rarely indicated for lower back pain. Mr Rajesh will consider surgery only if your back pain does not settle with an adequate trial of medications, physiotherapy and spine injections. He would always suggest minimally invasive surgery for less tissue dissection & a faster recovery. Mr Mangattil Rajesh is a skilful practitioner of minimally invasive spine surgery.

Minimally invasive spine surgery helps to release pressure on the nerves caused by disc prolapse or or your nerves trapped in the spinal canal. 

Some of the most common minimally invasive surgical procedures for lower back pain are:

  • Lumbar Microdiscectomy: It is the gold standard procedure for minimally invasive removal of herniated discs.
  • Lumbar Spine Decompression: This procedure is used for spinal stenosis where a piece of bone is removed from the spinal canal to release the pressure.

One of London’s best-reviewed spine surgeons, Mr Rajesh has treated thousands of patients with severe lower back pain successfully over the years. He forms a comprehensive lower back pain treatment plan personalised for your requirements. This is a combination of medication, exercises, spine injection and surgery wherever required.

Get in touch with him today. Mr Rajesh and his team would be happy to help you with your lower back pain treatment in London!

Recent Google Reviews of Mr Mangattil Rajesh


Mr Rajesh was excellent and I count myself very fortunate that he is my consultant surgeon. I could not have asked for a more courteous and professional experience. I could not fault anything. Mr Rajesh was very professional he explained everything in detail on all my visits. From initial consultation to post op Mr Rajesh took care of everything.

Dr Bhav Gami

Thank you so much to Mr Rajesh for helping my father when he was an inpatient at the height of the pandemic. Mr Rajesh is an amazing surgeon and was very informative, thorough and professional. Luckily my father was not infected with Covid 19 despite being an inpatient for 6 weeks.

Kemal Ykm

Dr Mangattil Rajesh is my hero he has helped me a great deal with my fractured back after a car accident. My recovery has improved significantly ever since he took on my case with regular consultations and real talk. He knows his stuff so I trust him with every decision we make together Lore Epsom.

Lower Back Pain Red Flags

Low back pain can be mild and merely annoying or it can be severe and debilitating. It may start slowly or it could start suddenly or you would have had pain now and then. But gradually the low back pains starts to get worse over time.

You have to be watchful for the lower back pain red flags – when your back pain is associated with:

1) Back pain with fever

2) Constant Back pain after a fall

3) Unexplained recent weight loss

4) Numbness or weakness of your leg

5) If you are over 50 years old!

6) Intravenous Drug Addictions

7) History of Breast Cancer

8) Long term Steroid treatment

So, beware of these red flags. Arrange to see a Consultant Spine Surgeon immediately.

Lower Back Pain Stretches

Mild exercises & stretches loosen your tense back and leg muscles. This helps release some pressure on the sciatic nerve and also strengthens other muscles to help you move.

It is advisable to take each step gently as any stretches that cause more strain on your back pain or leg pain can cause damage to your muscles.

Start with simple stretches with gentle forward bending, backward bending and mild twisting of your back within the limit of your back pain. Once you get used to it, slowly and gently move on to the following exercises.


Spine surgeon and Consultant Mr Rajesh recommends these 6 quick stretches as the best exercises for relief  from low back pain :

1) Hamstring Stretch

2) Pelvic Tilt

3) Extension Curl

4) Trunk Rotation

5) Pelvic Bridge

6) Sciatic Stretch


Perform these stretches as per the instructions in the below image and you’ll feel instant relief with your back pain and leg pain. These pain-relief exercises recommended by Mr Rajesh helps relieve the tension in your back and leg muscles.

Quick Sciatica Stretches at Home by Mangattil Rajesh Spine Surgeon London

Remember to breathe in and out slowly and deeply during these lower back pain-relief exercises. Also, stop whenever you feel any discomfort during the exercises. Always be gentle & aware!

As part of your personalised comprehensive lower back pain treatment plan, London back pain specialist Mr Mangattil Rajesh will guide you with more specialised physiotherapy and exercises to get complete relief from low back pain.

Lower Back Pain after COVID

Body aches and pain are also among the most frequently reported symptoms of COVID-19. The lower back is one of the most common places people with COVID-19 report feeling pain. General body aches, muscle pain, or joint pain are common symptoms of COVID-19 and other viral infections. It’s thought that back pain is part of the ‘flu-like’ symptom that is commonly seen in COVID.


Back pain often appears in the early stages of the disease, but it can also be a long-haul symptom that persists for weeks or months after infection. Back pain can have many possible causes. It’s impossible to know if your back pain was caused by COVID-19 unless you also had a positive COVID-19 diagnostic test. COVID-19 infection can stimulate the release of pro-inflammatory molecules called cytokines by the viral attack on your immune system. 


Back pain caused by COVID-19 is often described as a deep pain instead of a sharp or stabbing pain that may accompany a sudden muscular injury. Pain caused by viral infections is also less likely to be eased by changing your posture than the pain caused by muscular injuries.


Some people with COVID-19 develop symptoms that last weeks or months after the original infection. These persistent complications are called long-haul symptoms. Joint & back pain is one of the most common long haul symptoms of COVID-19.


Patients with any concern about their lower back pain should not hesitate to seek evaluation. It is always better to be reassured & start with pain relief measures that will stop the development of any long term pain/damage.


Have you started feeling persistent pain in your lower back after recovering from COVID-19? Feel free to contact the trusted back pain specialist in London Mr Mangattil Rajesh at 0203 1500 259!

Frequently Asked Questions about Lower Back Pain

The face is that most kind of back pain often go away without treatment, but if it occurs with any of the additional complications such as weight loss, fever, numbness or weakness of your legs, history of cancer or steroid treatment and loss of bladder or bowel control, then it is a serious situation.

You must seek advice immediately.

These are some of the ways to manage lower back pain at home:

  • Rest well. Take a break from work.
  • Keep Moving. Gentle activity like walking is good for back pain relief.
  • Apply heat or cold packs on the lower back (and legs, if there is a pain in the legs).
  • Over the counter pain medication helps you give instant relief from back pain.
  • Simple exercises and stretching
  • Strengthening core abdominal muscles help relieve back pain.
  • Bad sleeping postures can aggravate your back pain.
  • Make sure to lay flat on your back while sleeping.
  • Place a small, rolled up towel or a pillow under the small of your back for added support.
  • You may also place a pillow underneath your knees to keep your spine neutral.

Yes. Spinal injections are considered one of the safest options for pain management in the lower back and have been used for years. They provide excellent and instant pain relief. There are different types of Spine injections to suit the nature of back pain.

However, there are small but extremely rare risks involved like bleeding or infection at the injection site, post-injection headache, etc.

Spinal injections tend to provide temporary relief from pain, and the effects could last from one week up to one year. It is especially beneficial for a patient suffering from acute back and/or leg pain.

Most back pain gradually improves with home treatment and self-care, usually within a few weeks. Seek immediate attention from a qualified back pain specialist if your back pain:

  • Causes new bowel or bladder problems.
  • Is accompanied by fever.
  • Follows an injury, blow to your back or other injury.
  • Spreads down one or both legs, especially if the pain extends below the knee.
  • Causes weakness, numbness or tingling in one or both legs.
  • Is accompanied by unexplained weight loss.

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